Symptoms of Premenstrual Dysphoric Disorder (PMDD) can be physical, but are largely psychological, in nature. 

Below are the diagnostic criteria for PMDD (DSM-V5)

You may have PMDD if during most of your menstrual cycles during the past year, you had five (or more) of the following symptoms occurred during the final week before the onset of your period, and started to improve within a few days after your period started. At least one of your symptoms should be one of the top 4 symptoms (in bold) listed.

  • Marked affective lability (e.g., mood swings; feeling suddenly sad or tearful or increased sensitivity to rejection)

  • Marked irritability or anger or increased interpersonal conflicts

  • Markedly depressed mood, feelings of hopelessness, or self-deprecating thoughts

  • Marked anxiety, tension, feelings of being "keyed up" or "on edge"

  • Decreased interest in usual activities (e.g., work, school, friends, hobbies)

  • Subjective sense of difficulty in concentration

  • Lethargy, easy fatigability, or marked lack of energy

  • Marked change in appetite, overeating, or specific food cravings

  • Hypersomnia or insomnia (oversleeping or not being able to sleep)

  • A subjective sense of being overwhelmed or out of control

  • Other physical symptoms such as breast tenderness or swelling, joint or muscle pain, a sensation of "bloating," weight gain

The above list is by no means exhaustive (as many sufferers will tell you). Sensitivity to noise (misophonia), paranoia, wanting to run away from your life, suddenly feeling numb or 'out of love' with your partner, (and the list goes on and on) are all common complaints across PMDD support groups. 


Symptoms should be minimal or absent in the week after your period. If they are not, then it may be of interest to you to explore PME (Premenstrual Exacerbation). The correct diagnosis is important as treatment may differ. It is important to ensure the disturbance is not merely an exacerbation of the symptoms of another disorder, such as Major Depressive Disorder, Panic Disorder, Dysthymic Disorder, or a Personality Disorder (although it may be superimposed on any of these disorders).

The symptoms are associated with clinically significant distress or interferences with work, school, usual social activities or relationships with others (e.g. avoidance of social activities, decreased productivity and efficiency at work, school or home).

You need to track your symptoms as diagnosis “should be confirmed by prospective daily ratings during at least two symptomatic cycles”. (The diagnosis may be made provisionally prior to this confirmation.)

It is important to ensure that the symptoms are not due to the direct physiological effects of a substance (e.g., a drug of abuse, a medication or other treatment) or a general medical condition (e.g., hyperthyroidism).

In oral contraceptives users, a diagnosis of Premenstrual Dysphoric Disorder should not be made unless the premenstrual symptoms are reported to be present, and as severe, when they are not taking the oral contraceptive.